An outpouring of unheard stories: honouring the experiences of International Medical Graduate doctors
23 February 2024
Rini and Laura reflect on a Schwartz Round they facilitated at the Better Together: International Medical Graduates & Educators Conference.
Topics
Recently, we were delighted to be invited to facilitate a Schwartz Round at the Better Together: International Medical Graduates & Educators Conference organised by North East London NHS Foundation Trust. Attended by 80 delegates, this pan-London conference brought together doctors of all grades, medical & surgical specialities, particularly International Medical Graduates (IMGs) and their educators.
The organisers’ aims for this included recognising the successes and challenges for IMGs; understanding and mitigating differential attainment and providing a space to hear personal stories from those navigating systemic racism.
The theme of the Round was ‘The experiences of IMGs: Being on the outside and the inside’. As experienced Schwartz Rounds facilitators, we set this Round up in the usual way and yet were struck by what happened in the Round itself which was unique to us. Here we share our reflections on this, on the power of Schwartz Rounds and on the importance of providing safe spaces for sharing stories about isolation, discrimination, belonging and connection.
We are grateful to the conference organisers and to our three storytellers for enabling us to have this experience and for the learning and reflection we have gained from this.”
The experiences of International Medical Graduates
We are grateful to our three storytellers for being willing to share their experiences so generously and openly. As is often the case in Schwartz Rounds, all three stories were moving and powerful and clearly resonated with the audience. The stories contained themes of trauma and resilience, uprooting and rooting. The storytellers talked about their experiences of discrimination, microaggressions and exclusion, as well as of belonging, hope and connections, of survival, growth and endurance.
All of our storytellers wanted to do whatever they could to ensure that what had happened to them did not happen to others. They had resisted calls to change and to ‘fit in’ – they remained their authentic selves saying, ‘This is who I am’.
Unlike any other Schwartz Round either of us had previously experienced, when all three storytellers had spoken and we transitioned to inviting those in the audience to share how the stories had resonated with them and to share their own stories, there was a complete out-pouring of feelings and stories. Contributions flowed fast, one after another, and the audience clapped after each person spoke – a way of honouring each story and contribution.
The flow of sharing was such that part way through, we found we needed to gently facilitate to slow this down, to pause and notice what might be going on for them as a group. Every person who spoke had their own story to share that connected with the storytellers’ stories. IMGs spoke of their relief and appreciation of being seen and heard – ‘This is my story’.
It was immediately apparent that the stories being told and shared in this Schwartz Round had not previously been given – or allowed – a safe space. One of the conference organisers is an IMG and this was crucial in setting the event’s tone, intent and content. A powerful presentation that preceded the Round ended with the statement ‘I see you’ – an overt recognition of the discrimination and othering that IMGs experience, an affirmation of solidarity and a recognition of survival and thriving.
How do we create more of these spaces?
The sharing and validating of stories began to create a safe and supportive space, bringing many IMGs together. This makes us wonder, how do we create more of these spaces? How do we make this a more everyday experience? How can we enable NHS staff, especially trainees, to share their experiences with each other, to be heard and to be able to be their authentic selves at work?
We are grateful to the conference organisers and to our three storytellers for enabling us to have this experience and for the learning and reflection we have gained from this. We noticed and reflected on generational differences in the stories shared, encouraged by the context of current identity politics and the naming and calling out of microaggressions and discrimination when it happens, of empowerment, speaking up and allyship.
Beyond highlighting the power of Schwartz Rounds, this shines a light on the need for such spaces to be offered and supported in the NHS and during clinical training.
For us, this was a Round that we will always remember.
Acknowledgements
With many thanks to our three storytellers, Shazia Hashmi, Monisha Mishra and Lia López and the conference organisers, Harleen Birgi and Peter Carter.